Acyclovir, amphotericin B, cisplatin, methoxyflurane, vancomycin, other aminoglycosides: gold.raiditem increased ototoxicity and nephrotoxicity. Use together cautiously. Cephalosporins: increased nephrotoxicity. Use together cautiously. Dimenhydrinate: may mask symptoms of ototoxicity. Use with caution. General anesthetics, neuromuscular blockers: may potentiate neuromuscular blockade. Monitor closely. Indomethacin: may increase serum peak and trough levels of gentamicin. Serum gentamicin ]evels must be monitored closely Buy ASTA Online Gold. I. V. loop diuretics (such as furosemide): increased ototoxicity. Use cautiously. Parenteral penicillins (such as ampicillin and ticarcillin): gentamicin inactivation in vitro. Don’t mix together. EFFECTS ON DIAGNOSTIC TESTS None reported. CONTRAINDICATIONS Contraindicated in hypersensitivity to drug or other aminoglycosidesSPECIAL CONSIDERATIONS ” Use cautiously in neonates, infants, elderly patients, and patients with impaired renal function or neuromuscular disorders.” A specimen for culture and sensitivity tests is obtained before first dose is given. ” Patient’s hearing must be evaluated before and during therapy. Patient complaints of tinnitus, vertigo, or hearing loss are important. ” Patient’s weight and renal function studies must be reviewed before therapy begins. ” Alert: Preservative-free formulations of gentamicin are used when the intrathecal route is ordered. ” Blood for peak gentamicin level is obtained I hour after I.M. injection or 30 minutes after LV. infusion finishes; for trough levels, blood is drawn just before next dose . Blood must not be collected in a heparinized tube; heparin is incompatible with aminoglycosides. ” Peak blood levels over 10 mcg/ml and trough levels over 2 mcg/m] may be associated with higher incidence of toxicity. ” Urine output, specific gravity, urina]ysis, BUN and creatinine levels, and creatinine clearance must be monitored. ” Hemodialysis for 8 hours removes up to 50% of drug from blood.
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